Fiscal austerity and the health sector: the cost of adjustments

Abstract

Fiscal austerity policies have been used as responses to economic crises and fiscal deficits in both developed and developing countries. While they vary in regard to their content, intensity and implementation, such models recommend reducing public expenses and social investments, retracting the public service and substituting the private sector in lieu of the State to provide certain services tied to social policies. The present article discusses the main effects of the recent economic crisis on public health based on an updated review with consideration for three dimensions: health risks, epidemiological profiles of different populations, and health policies. In Brazil, the combination of economic crisis and fiscal austerity policies is capable of producing a direr situation than those experienced in developed countries. The country is characterized by historically high levels of social inequality, an under-financed health sector, highly prevalent chronic degenerative diseases and persisting preventable infectious diseases. It is imperative to develop alternatives to mitigate the effects of the economic crisis taking into consideration not only the sustainability of public finance but also public well-being.

Convergence in alcohol abuse in Brazilian capitals between genders, 2006 to 2019: what population surveys show

“…North-American studies from the National Alcohol Survey, using the binge drinking indicator, found increased risk of alcohol consumption among women with college education or higher 33 . There are also the effects of economic and political crisis in the health indicators 34 , since the reduction of income and REV BRAS EPIDEMIOL 2021; 24: E210022.SUPL.1 unemployment can reduce the expenses with alcohol, especially in the populations that are mostly affected economically 25,35,36 . On the other hand, the pathological suffering and the stress caused by reduced income and unemployment may lead to more alcohol consumption 35 .…”

Equality and poverty: views from managers and professionals from public services and household heads in the Belo Horizonte Metropolitan Area, Brazil

“…Regardless of the country's economic crisis, it is necessary to value social rights together with economic growth, prioritizing action that targets the most vulnerable territories [50,53,[56][57][58][59]. The effects of economic crises in developing countries must be mitigated, prioritizing sustainable public funding of public services to the benefit of public welfare and progressively reducing potential health risks [60]. Greater investments are needed in social security, based on the BCE approach, in order to maximize human capital development (basic capabilities and personal potential), ensure adequate well-being, and fulfil the rights to health, education, social security and urban infrastructure.…”

Equality and Poverty: Views From Managers and Professionals From Public Services and Household Heads in the Belo Horizonte Metropolitan Area, Brazil

“…Regardless of the country's economic crisis, it is necessary to value social rights together with economic growth, prioritizing action that targets the most vulnerable territories 50,53,[56][57][58][59] . The effects of economic crises in developing countries must be mitigated, prioritizing sustainable public funding of public services to the benefit of public welfare and progressively reducing potential health risks 60 .…”